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Salud Publica de Mexico 1981
Topics: Female; Humans; Legionnaires' Disease; Male; Mexico
PubMed: 7268546
DOI: No ID Found -
New South Wales Public Health Bulletin 2007
Topics: Aged; Humans; Legionnaires' Disease; Middle Aged; New South Wales; Public Health Practice; Risk Factors
PubMed: 17649607
DOI: 10.1071/nb07033 -
Israel Journal of Medical Sciences Mar 1979The fist case of legionnaires' disease in Israel is described. In a previously healthy woman, the disease was manifested by a rapidly progressive pneumonia, which was...
The fist case of legionnaires' disease in Israel is described. In a previously healthy woman, the disease was manifested by a rapidly progressive pneumonia, which was unresponsive to conventional therapy. The diagnosis was confirmed by positive serologic tests and the demonstration of the responsbile microorganism in the patient's lung tissue. Legionnaires' disease should now be suspected in patients with unexplained severe pneumonia, even in countries in which this disease has not been previously recognized.
Topics: Adult; Female; Humans; Israel; Legionnaires' Disease; Lung
PubMed: 457374
DOI: No ID Found -
Legionella surveillance: political and social implications--a little knowledge is a dangerous thing.The Journal of Infectious Diseases Jan 2002
Topics: Disinfection; Health Education; Humans; Legionnaires' Disease; Travel; Water Microbiology
PubMed: 11807701
DOI: 10.1086/338265 -
Frontiers in Cellular and Infection... 2021Legionellales-infected water is a frequent cause of local outbreaks of Legionnaires' disease and Pontiac fever. Decontaminations are difficult because Legionellales...
Legionellales-infected water is a frequent cause of local outbreaks of Legionnaires' disease and Pontiac fever. Decontaminations are difficult because Legionellales reproduce in eukaryotic microorganisms (protists). Most often, Legionellales have been isolated from amoebae; however, the culture-based sampling methods are taxonomically biased. Sequencing studies show that amoebae in the cercozoan class Thecofilosea are dominant in soils and wastewater treatment plants, prompting us to screen their capability to serve as potential hosts of endosymbiotic bacteria. Environmental isolates of Thecofilosea contained a surprising richness of endosymbiotic Legionellales, including . Considering the widespread dispersal of Legionellales in apparently unrelated amoeboid protist taxa, it appears that the morphotype and not the evolutionary origin of amoebae determines their suitability as hosts for Legionellales. We further provide a protocol for gnotobiotic cultivation of Legionellales and their respective hosts, facilitating future genomic and transcriptomic research of host-symbiont relationships.
Topics: Amoeba; Amoebida; Bacteria; Humans; Legionella; Legionnaires' Disease
PubMed: 33763389
DOI: 10.3389/fcimb.2021.642216 -
Seminars in Respiratory Infections Jun 1998Legionnaires' disease is a modern environmental infectious disease. It stems from the capacity of the causative agent, Legionella, to multiply within amoebae in warm... (Review)
Review
Legionnaires' disease is a modern environmental infectious disease. It stems from the capacity of the causative agent, Legionella, to multiply within amoebae in warm water and the use, during the 20th century, of devices that maintain water at warm temperatures and produce aerosols. When contaminated with Legionella, aerosols consisting of respirable droplets place the bacteria in juxtaposition with alveolar macrophages, which, as with amoebae, they may parasitize, resulting in illness in susceptible persons. The disease is much more common than previously appreciated with at least 13,000 cases estimated to occur per year in the United States, based on prospective studies. Two highly specific tests, urinary antigen detection and sputum culture, are available for diagnosis during illness. With 60% to 80% sensitivity, urinary antigen tests rapidly detect antigens of Legionella pneumophila serogroup 1, which are responsible for 70% of the cases of legionnaires' disease; results can be available within a few hours. Culture of sputum is 50% to 60% sensitive, but several days are required for growth, and many patients do not produce sputum. Serologic testing, although useful for epidemiologic studies when convalescent-phase antibody titers can be compared with acute-phase titers, is not helpful for clinical decision making because of the low positive predictive value of commercially available acute-phase serologic tests. Erythromycins, intravenous azithromycin, and levofloxacin are currently approved by the US Food and Drug Administration for treatment of legionnaires' disease. However, clarithromycin and several other fluoroquinolones are active against Legionella and may also provide effective therapy. Recent recommendations from the Centers for Disease Control and Prevention's Hospital Infection Control Practices Advisory Committee should be helpful in reducing nosocomial legionnaires' disease. Recommendations are in place or are being developed to minimize the risk of disease in a variety of other settings.
Topics: Communicable Disease Control; Disease Outbreaks; Humans; Legionnaires' Disease; Public Health; United States
PubMed: 9643385
DOI: No ID Found -
American Journal of Respiratory... 2003Infection with Legionella spp. is an important cause of serious community- and hospital-acquired pneumonia, occurring sporadically and in outbreaks. Outbreaks of... (Review)
Review
Infection with Legionella spp. is an important cause of serious community- and hospital-acquired pneumonia, occurring sporadically and in outbreaks. Outbreaks of Legionnaires' disease have recently received considerable media attention, and some factors indicate that the problem will increase in future. Infection with Legionella spp. ranks among the three most common causes of severe pneumonia in the community setting, and is isolated in 1-40% of cases of hospital-acquired pneumonia. Underdiagnosis and underreporting are high. Only 2-10% of estimated cases are reported. Detection of a single case should not be considered an isolated sporadic event, but rather indicative of unrecognized cases. There are no clinical features unique to Legionnaires' disease; however, suspicion should be raised by epidemiologic information commensurate with the diagnosis and the presence of headache, confusion, hyponatremia, elevated creatine kinase and/or severe pneumonia. An arterial oxygen partial pressure <60mm Hg on presentation and progression of pulmonary infiltrates despite appropriate antibacterial therapy should always alert clinicians to this cause.Macrolides, fluoroquinolones and rifampin (rifampicin) are the most widely used drugs in treatment. Fluoroquinolones or azithromycin are the treatment of choice in immunosuppressed patients and those with severe pneumonia. Incorporation of the legionella urinary antigen test in emergency departments in hospitals and progressive improvement in this test will, in the near future, permit appropriate diagnosis and treatment of this frequent, sometimes severe, illness.
Topics: Anti-Bacterial Agents; Humans; Legionnaires' Disease
PubMed: 14720005
DOI: 10.1007/BF03256652 -
La Revue de Medecine Interne Jul 2022Legionnaire's disease is a community-acquired pneumonia caused by the Gram-negative bacterium Legionella pneumophila. This disease is often associated with neurological... (Review)
Review
INTRODUCTION
Legionnaire's disease is a community-acquired pneumonia caused by the Gram-negative bacterium Legionella pneumophila. This disease is often associated with neurological symptoms, the clinical presentation of which can be very varied.
CASE REPORT
We report a 47-year-old female patient who developed Legionnaires' disease with cerebellar symptoms (ataxia, dysarthria and hypermetria). Laboratory tests revealed a biological inflammatory syndrome. The cerebrospinal fluid was sterile. Urinary antigen test and serology were positive for L. pneumophila. An interstitial syndrome of the right upper lobe was detected on chest computed tomography (CT) scan. Brain imaging (magnetic resonance imaging and CT angiography) showed no abnormalities. The outcome was favourable after treatment with spiramycin, levofloxacin and corticosteroids.
DISCUSSION
Few cases only (n=110) of Legionnaires' disease with cerebellar symptoms have been reported in the literature. The pathogenic mechanism behind neurological dysfunction in patients with Legionnaires' disease is unknown. Neurological symptoms improve with antibiotic therapy and corticosteroids. Extra-pulmonary forms of Legionnaires' disease are frequent, with neurological symptoms being the most common symptoms. Cerebellar dysfunction may be underestimated and requires appropriate management with antibiotic therapy and corticosteroid therapy. Recommendations for the management of Legionnaire's disease with severe extra-pulmonary symptoms are needed.
Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Cerebellar Diseases; Female; Humans; Legionella pneumophila; Legionnaires' Disease; Middle Aged
PubMed: 35643782
DOI: 10.1016/j.revmed.2022.04.023 -
Current Opinion in Pulmonary Medicine May 2008This review provides clinicians with an overview of the clinical features of the atypical pneumonias. Atypical community-acquired pneumonia pathogens cause systemic... (Review)
Review
PURPOSE OF REVIEW
This review provides clinicians with an overview of the clinical features of the atypical pneumonias. Atypical community-acquired pneumonia pathogens cause systemic infections with pneumonia. The key to the clinical diagnosis of atypical pneumonias depends on recognizing the characteristic pattern of extrapulmonary organ involvement different for each pathogen. As Legionella is likely to present as severe pneumonia and does not respond to beta-lactams, it is important to presumptively diagnose Legionnaires' disease clinically so that Legionella coverage is included in empiric therapy. This study reviews the clinical features and nonspecific laboratory markers of atypical pathogens, focusing on Legionnaires' disease.
RECENT FINDINGS
Case reports/outbreaks increase our understanding of Legionnaires' disease transmission. Both Mycoplasma pneumoniae and Chlamydophilia pneumoniae may cause asthma. Antimicrobial therapy of Chlamydophilia pneumoniae/Mycoplasma pneumoniae is important to decrease person-to-person spread and to decrease potential long-term sequelae.
SUMMARY
Atypical pulmonary pathogens cause systemic infections accompanied by a variety of characteristic extrapulmonary features. Clinically, it is possible to differentiate Legionnaires' disease from the other typical/atypical pneumonias. Rapid clinical diagnosis of atypical pathogens, particularly Legionnaires' disease, is important in selecting effective empiric therapy and prompting definitive laboratory testing.
Topics: Humans; Legionnaires' Disease; Pneumonia, Bacterial
PubMed: 18427241
DOI: 10.1097/MCP.0b013e3282f79678 -
American Journal of Respiratory and... Feb 2016
Topics: Humans; Legionnaires' Disease; Patient Education as Topic; Risk Factors
PubMed: 26871677
DOI: 10.1164/rccm.1934P5